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Adolescents are the most frequent users of complementary and alternative medicines (CAM) in pediatrics. Investigators linked data from two national studies (representing 33 million youth aged 10–17 years) to examine use of CAM and conventional therapies among youth with recurrent headache.
Of the 11% of youth with recurrent headache, almost one third had used one or more types of CAM in the past year (vs. 17% of youth without headache). Compared with nonusers, CAM users were more likely to be age 16 or 17 years, white, live in households with higher incomes and maternal education levels, and have private health insurance. Youth who used CAM also were significantly more likely to have at least one other chronic health condition (94% vs. 83%); have difficulties with emotions, concentration, or behavior (20% vs. 13%); have limited functioning in daily activities (25% vs. 15%); and miss school for ≥2 weeks (22% vs. 8%) during the past year. The most commonly used therapies were vitamins/minerals (18%), herbal supplements (10%), deep-breathing exercises (9%), chiropractic/osteopathic manipulation (5%), CAM practices (yoga, tai chi, or qi gong, 5%; meditation or massage, 3% each). Youth with headaches who used CAM utilized significantly more health care resources and had greater healthcare expenditures (US$2929) than youth with headache who did not use CAM ($2013) and youth without headaches ($1503).
Bethell C et al. Complementary and conventional medicine use among youth with recurrent headaches. Pediatrics 2013 Oct 14; [e-pub ahead of print]. (http://dx.doi.org/10.1542/peds.2013-1816)
Comment
The association between complementary and alternative medicine use and higher socioeconomic status, white race, and private insurance suggests that lower-income minority youth are not able to benefit from CAM therapies proven to help reduce headache frequency. The finding that CAM users often have multiple health conditions and use more conventional health services highlights the need for comprehensive assessment and coordinated care for these young people.